产前MRI对凶险型前置胎盘伴胎盘植入患者的诊断价值分析

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中文摘要：目的:探究产前MRI在凶险型前置胎盘伴胎盘植入中的临床应用价值。方法:选取 2022年 1月—2023年 6月在合肥市妇幼保健院接受治疗的 86例疑似凶险型前置胎盘伴胎盘植入患者为研究对象，以手术病理检查结果为金标准，患者均在产前接受MRI和超声检查。对比超声检查和MRI检查的阳性、阴性检出情况及灵敏度、特异度、准确度等诊断效能;采用Kappa检验验证不同检查方法诊断与金标准的一致性。结果:在 86例疑似凶险型前置胎盘伴胎盘植入患者中，手术病理检查结果确诊阳性患者 62例。超声检查阳性检出 56例，阴性检出 30例;MRI检查阳性检出 60例，阴性 26例。MRI检查的灵敏度为 93。55%、准确度为 93。02%、特异度为 91。67%、阳性预测值为 96。67%、阴性性预测值为 84。62%，均高于超声检查的 78。22%、72。09%、62。50%、83。93%、50。00%，差异均有统计学意义(P<0。05)。超声检查诊断与手术病理检查结果的Kappa=0。356，一致性欠佳;MRI检查诊断与手术病理检查结果的Kappa=0。831，一致性极好。结论:在凶险型前置胎盘伴胎盘植入患者中采用MRI检查的诊断价值高于超声检查，更有利于临床医师判断出患者有无发生前置胎盘植入，从而为凶险型前置胎盘伴胎盘植入患者提供更有利的治疗方案。

外文标题：Diagnostic Value of Prenatal MRI in Patients with Dangerous Placenta Previa with Placenta Implantation

外文摘要：Objective:To investigate the clinical application value of prenatal MRI in the diagnosis of dangerous placenta previa with placenta implantation.Methods:A total of 86 patients with suspected dangerous placenta previa with placenta implantation who were treated in the Hefei Maternal and Child Health Hospital from January 2022 to June 2023 were selected as the study objects.The results of surgical pathological examination were used as the gold standard.All patients received MRI and ultrasound examinations before delivery.The positive and negative detection,sensitivity,specificity and accuracy of ultrasound and MRI were compared.Kappa test was used to verify the consistency of different diagnostic methods with the gold standard.Results:Among 86 patients with suspected dangerous placenta previa with placenta implantation,62 patients were confirmed positive by pathological examination.56 cases were positive and 30 cases were negative.MRI was positive in 60 cases and negative in 26 cases.The sensitivity,accuracy,specificity,positive predictive value and negative predictive value of MRI were 93.55%,93.02%,91.67%,96.67%and 84.62%respectively,which were higher than 78.22%,72.09%,62.50%,83.93%and 50.00%of ultrasound.The differences were statistically significant(P<0.05).The Kappa=0.356 of ultrasonic diagnosis was not consistent with that of pathological examination.The Kappa=0.831 of MRI diagnosis and pathological examination results was in good agreement.Conclusion:The diagnostic value of MRI is higher than ultrasound in patients with dangerous placenta previa with placenta implantation,which is more conducive to clinicians to determine whether patients have placenta previa implantation,so as to provide a more favorable treatment plan for patients with dangerous placenta previa with placenta implantation.

外文关键词：

Dangerous placenta previaPlacental implantationNuclear magnetic resonanceDiagnostic valueAntenatal

作者：

陆倩

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作者单位：

安徽省合肥市妇幼保健院医学影像中心,安徽合肥 230000

关键词：

凶险型前置胎盘胎盘植入核磁共振诊断价值产前

出版年：

2024

DOI：